Cerebral microbleeds are a risk factor for warfarin-related intracerebral hemorrhage.

Abstract

BACKGROUND:

Cerebral microbleeds are known to be indicative of bleeding-prone microangiopathy and may predict incident intracerebral hemorrhage (ICH). In this study, we investigated whether microbleeds are associated with the incidence of warfarin-related ICH.

METHODS:

Twenty-four patients with ICH while on outpatient treatment with warfarin were selected from a consecutive cohort. Control, warfarin-using subjects with no history of ICH were randomly selected during the same time period (n = 48). We compared demographic factors, vascular risk factors, laboratory findings, and radiologic findings including microbleeds between the groups.

RESULT:

There were more cases of patients with microbleeds in the ICH than control group (79.2% vs 22.9%: p < 0.001), and the number of microbleeds was much higher for the ICH group (9.0 +/- 26.8 vs 0.5 +/- 1.03: p < 0.001). Moreover, the number of microbleeds was significantly correlated with the presence of warfarin-related ICH (r = 0.299; p < 0.001). Conditional logistic regression analysis showed that increased prothrombin time and the presence of microbleeds were independently related to the incidence of warfarin-related ICH (microbleeds: adjusted OR, 83.12).

CONCLUSION:

This study suggests that underlying microbleeds are independently associated with an incidence of warfarin-related intracerebral hemorrhage. Future research should focus on elucidating the risks and benefits of warfarin medication in patients with microbleeds.

• Authors: Seung-Hoon Lee, Wi-Sun Ryu, Jae-Kyu Roh
• Journal: Neurology (Neurology) Vol. 72 Issue 2 Pg. 171-6 (Jan 13 2009) ISSN: 1526-632X [Electronic] United States
• PMID: 19139370 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Warfarin

Topics

• Aged
• Anticoagulants (adverse effects)
• Arterioles (drug effects, pathology, physiopathology)
• Brain (blood supply, pathology)
• Cerebral Arteries (drug effects, pathology, physiopathology)
• Cerebral Hemorrhage (chemically induced, epidemiology, physiopathology)
• Female
• Humans
• Incidence
• Intracranial Thrombosis (drug therapy)
• Male
• Microcirculation (drug effects, physiology)
• Middle Aged
• Prothrombin Time
• Risk Factors
• Warfarin (adverse effects)